Shin Splints vs Stress Fracture – Don’t Guess

If you’re a runner in Newcastle dealing with shin pain, you’ve probably wondered: “Is this just shin splints, or could it be a stress fracture?”

Both conditions cause pain in a similar area, but the management is very different. Misreading the signs can mean weeks — or months — of unnecessary downtime.

At Up N Adam Performance Training & Physiotherapy, we help runners figure this out every week. Here’s how to spot the differences and when to get it checked.

What Are Shin Splints?

“Shin splints” is the everyday term for medial tibial stress syndrome (MTSS).

Typical features:

• Diffuse (spread-out) pain along the inside of the shin bone

• Pain comes on at the start of a run, may ease during, then return later

• Usually linked to run technique &/or training errors — sudden increase in mileage, hills, or hard surfaces

What Is a Stress Fracture?

A stress fracture is a small crack in the bone from overload.

Typical features:

• Localised, pinpoint pain (you can press on a specific spot)

• Pain starts earlier in the run, builds up, and may persist afterwards

• Often worsens to pain at rest or at night if ignored

• High risk if untreated — may require weeks of full rest or even a boot

When to See a Physio

Don’t try to guess. Book an assessment if you have:

• Shin pain persisting >2 weeks

• Night/rest pain in the shin

• Training load increases before pain started

• Tenderness on the shin bone

At Up N Adam, we use:

• History & clinical tests to differentiate MTSS vs stress fracture

• VALD testing & gait analysis to find overload factors (hip/ankle strength, stride length, run technique)

• Referral for imaging if a stress fracture is strongly suspected

Management Principles

For Shin Splints (MTSS):

• Modify training load (surface, mileage, hills)

• Strengthen calves, hips, and core

• Check run technique with video analysis

• Gradual return with monitoring

• Local treatment with massage & dry needling

For Stress Fractures:

• Strict rest from running (weeks, not days)

• Possible boot use if severe

• Address nutrition, recovery, and load patterns before returning

• Gradual run progression once healed

FAQs

Q: Can I keep running with shin splints?

Sometimes — with reduced load. But if pain worsens or persists, rest may be needed.

Q: How do I know if it’s a stress fracture without a scan?

You can’t be 100% sure — but pinpoint tenderness, night pain, and worsening symptoms are red flags.

Q: Do I always need a scan for shin pain?

Not always. A physio assessment usually identifies the likely cause. Scans are ordered when a stress fracture is suspected.

Call to Action

If shin pain is stopping you from running, don’t give up. Our physios in Hamilton North can assess whether it’s shin splints or something more serious and provide you with the care required.

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com .

Bookings also available on our website for the following services at Up N Adam Performance Training & Physiotherapy:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fuelling www.nutrientnation.com.au

• VO2 Max testing with Lucas McBeath - to discover more effective ways to train efficiently www.flowitri.com.au

• Strength & Conditioning Programs with Adam Clarke - contact us or book via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage with Katheryn Rodgers - to relieve accumulative muscle tension & keep you training well.

• CycleFit by Physiotherapist Dean Waterman - At Up N Adam, for all your bike fitting solutions www.cyclefitphysio.com